Backgrounds Moral distress significantly affects pediatric ICU nurses, leading to nurse burnout, increased turnover and reducing patient care quality. Despite its importance, there’s a notable gap in knowledge on how to manage it effectively. Aims This review aimed to systematically identify and analyze coping strategies and interventions targeting moral distress among pediatric nurses in ICU, uncovering research gap and future studies directions. Methods A scoping review was conducted followed framework by Levac, Colquhoun, and O'Brien and Arksey and O'Malley. Searches were (...) performed in 11 electrical databases, like PubMed and China Biology Medicine disc, within a timeframe of the database construction to November 2023, and performed literature screening and data extraction. Results Sixteen articles were ultimately included. Coping strategies adopted by pediatric ICUs nurses can be categorized into adaptive and maladaptive strategies, with the latter including passive acceptance, taking leave, and drinking, while the former involve pursuing interests outside of work, reflection and philosophizing, and communication. Nine articles described and evaluated the effectiveness of interventions for moral distress, categorizing them into individual and institutional levels. Individual-level interventions include Interprofessional Perspective-Taking, the PICU Resiliency Bundle, Ethics Education/Skills, and the Center for Caring. Institutional-level interventions encompasses Comprehensive Care Round, Goals of Care Conversations, Pediatric Ethics and Communication Excellence Rounds, Nursing Ethics Council, and Medical Ethical Decision-Making, though not all were effective in alleviating moral distress. Conclusions Nurses often use self-adjustment strategies for moral distress, institutional ethical support focusing on enhancing nurses’ moral resilience, promoting reflective thinking and improving communication remains crucial. Various interventions for moral distress are currently available, but nurse engagement is low and their effectiveness remained to be verified. Future studies should explore what aids or hinders these interventions. There’s also a need for large, multicenter trials and ongoing evaluations to create effective support systems for pediatric ICU nurses. (shrink)

In his Knowledge and Belief (1962), Hintikka establishes his system of epistemic logic with the KK (Knowing that One Knows, in symbols, Kp→KKp) principle (KK for short). However, his system of epistemic logic and the KK principle are grounded upon his strong notion of knowledge, which requires that knowledge is infallible, that is, it makes further inquiry pointless, and becomes ‘discussion-stopper’; knowledge implies truth, to wit, cognitive agents will not be mistaken in their knowledge; cognitive agents will be ‘perfect logicians’, (...) i.e. they have infinitive capability of logical inference. Hintikka calls the argument for KK from the strong notion of knowledge as the ‘transcendental argument’ for KK. Obviously, the strong notion of knowledge is far away from our ordinary conception of knowledge; based on such a strong sense of knowledge, epistemic logic has met the problem of logical omnipotence, and is difficult to apply in our ordinary cognitive practice. Moreover, there is no close connection of the KK principle with internalism or externalism. (shrink)

This paper divides the sophisms and paradoxes put forth by Chinese thinkers of the pre-Qin period of China into six groups: paradoxes of motion and infinity, paradoxes of class membership, semantic paradoxes, epistemic paradoxes, paradoxes of relativization, other logical contradictions. It focuses on the comparison between the Chinese items and the counterparts of ancient Greek and even of contemporary Western philosophy, and concludes that there turn out to be many similar elements of philosophy and logic at the beginnings of Chinese (...) and Greek civilizations. (shrink)

In this paper, I introduce an intrinsic account of the quantum state. This account contains three desirable features that the standard platonistic account lacks: (1) it does not refer to any abstract mathematical objects such as complex numbers, (2) it is independent of the usual arbitrary conventions in the wave function representation, and (3) it explains why the quantum state has its amplitude and phase degrees of freedom. -/- Consequently, this account extends Hartry Field’s program outlined in Science Without Numbers (...) (1980), responds to David Malament’s long-standing impossibility conjecture (1982), and establishes an important first step towards a genuinely intrinsic and nominalistic account of quantum mechanics. I will also compare the present account to Mark Balaguer’s (1996) nominalization of quantum mechanics and discuss how it might bear on the debate about “wave function realism.” In closing, I will suggest some possible ways to extend this account to accommodate spinorial degrees of freedom and a variable number of particles (e.g. for particle creation and annihilation). -/- Along the way, I axiomatize the quantum phase structure as what I shall call a “periodic difference structure” and prove a representation theorem as well as a uniqueness theorem. These formal results could prove fruitful for further investigation into the metaphysics of phase and theoretical structure. -/- (For a more recent version of this paper, please see "The Intrinsic Structure of Quantum Mechanics" available on PhilPapers.). (shrink)

Our paper draws attention to a neglected channel of corruption—the bribe payments by state-owned enterprises. This is an important phenomenon as bribe payments by SOEs fruitlessly waste national resources, compromising public welfare and national prosperity. Using a large dataset of 30,249 firms from 50 countries, we show that, in general, SOEs are less likely to pay bribes for achieving organizational objectives owing to their political connectivity. However, in deteriorated institutional environments, SOEs may be subjected to potential managerial rent-seeking behaviors, which (...) disproportionately increase SOE bribe propensity relative to privately owned enterprises. Specifically, our findings highlight the importance of fostering democracy and rule of law, reducing prevalence of corruption and shortening power distance in reducing the incidence of SOE bribery. (shrink)

Background: Moral distress occurs when nurses experience ethical dilemmas. Issues related to these dilemmas are addressed in some nursing education courses. Nurses’ reaction to dilemma such as moral distress is relatively less noticed. Objective: This study aimed to identify and describe the various types of perceptions of moral distress exhibited by nurses. Research design: This study applied Q methodology to explore the perspectives of nurses regarding moral distress. Data were collected in two stages. First, in-depth interviews were conducted to collect (...) nurses’ opinions. Sentences that best fit the concepts of moral distress were extracted for the construction of Q statements. Second, nurses subjectively ranked these Q statements so that the relevant severity of moral distress could be determined using Q sorts. The study participants were nurses at a regional teaching hospital in northeast Taiwan. A total of 60 participants were invited to rank 40 moral distress Q statements. Ethical considerations: The study protocol was approved by the institutional review board of National Yang-Ming University Hospital. Only the participants who signed an informed consent form participated in the study. The respondents’ right to withdraw from the study was respected. Findings: Five types of responses were identified regarding the nurses’ perspectives. These types were “conflict with personal values,” “excessive of workload,” “curbing of autonomy,” “constraint engendered by organizational norms,” and “self-expectation frustration.” Conclusion: The findings regarding nurses’ experiences of moral distress can be used to construct multifaceted policies and solutions and to incorporate ethical education in training programs. (shrink)

Background: Chinese Taoist cognitive therapy (CTCT), a culture-oriented psychological therapy for Chinese mental well-being, has been proposed for decades. However, the evidence for its effects is unclear. This study aimed to systematically assess the effect of this therapy on symptoms of depression and anxiety in Chinese adults. Methods: Relevant studies were searched from major electronic databases through November 2018 without language limits. Several search terms used include “anxiety” OR “depression” AND “Taoism” OR “Daoism” OR “Chinese Taoist Cognitive Therapy”. A total (...) of 11 clinical trials focusing on CTCT were included in this meta-analysis. Random-effects meta-analytical models were conducted. Heterogeneity and publication bias were also explored. Results: Eight clinical trials for 580 subjects were included. The majority of these studies explored samples with depressive symptoms. Overall, CTCT significantly reduced depressive symptoms with a small positive effect (SMD = 0.16, 95% CI: -0.36-0.68). Medium-to-large effect sizes were observed across individuals with clinical or nonclinical depression and chronic physical diseases (SMD = 0.70, 95%CI: 0.27-1.13 and SMD = 0.72, 95%CI: 0.09-1.35, respectively). However, the effectiveness for anxiety symptoms remains debatable. Conclusions: Our findings hold promise that CTCT can help reduce depressive symptoms in Chinese adults, including patients with chronic physical diseases and clinical or nonclinical depression. Our findings may be generalized to Chinese communities in other countries. (shrink)

The present study investigated whether another individual’s gaze direction influences an observer’s affective responses. In Experiment 1, subjective self-ratings and an affective priming paradigm were employed to examine how participants explicitly and implicitly, respectively, evaluated the affective valence of direct gaze, averted gaze, and closed eyes. The explicit self-ratings showed that participants evaluated closed eyes more positively than direct gaze. However, the implicit priming task showed an inverse pattern of results indicating that direct gaze was automatically evaluated more positively than (...) closed eyes were. Experiment 2 confirmed that the opposite patterns of results between the two tasks were not due to differences in presentation times of the gaze stimuli. The results provide evidence for automatic affective reactions to eye gaze and indicate a dissociation between explicit and implicit affective evaluations of eyes and gaze direction. (shrink)

With the rapid and unbalanced development of industry, a large amount of cultivated land is converted into industrial land with lower efficiency. The existing research is extensively concerned with industrial land use and industrial development in isolation, but little attention has been paid to the relationship between them. To help address this gap, the paper creates a new efficiency measure method for industrial land use combining Subvector Data Envelope Analysis with spatial analysis approach. The proposed model has been verified by (...) using the industrial land use data of 30 Chinese provinces from 2001 to 2013. The spatial autocorrelation relationship between industrial development and industrial land use efficiency is explored. Furthermore, this paper examines the effects of industrial development on industrial land use efficiency by spatial panel data model. The results indicate that the industrial land use efficiency and the industrial development level in the provinces of eastern region are higher than those of the western region. The spatial distribution of industrial land use efficiency shows remarkable positive spatial autocorrelation. However, the level of industrial development has obvious negative spatial autocorrelation since 2009. The improvement of industrial development has a significant positive impact on the industrial land use efficiency. (shrink)

Based on social cognitive theory, we theorize that collective efficacy plays a mediating role in the relationship between paternalistic leadership and organizational commitment and that this mediating role depends on team cohesion. The empirical results from a study of 238 employees from 52 teams at manufacturing companies show that benevolent leadership and moral leadership, both components of paternalistic leadership, are positively related to organizational commitment and further that collective efficacy mediates the moral leadership–organizational commitment relationship. We did not find a (...) relationship between authoritarian leadership and organizational commitment. Besides, it was found that team cohesion negatively moderates the relationship between moral leadership and collective efficacy and positively moderates the relationship between collective efficacy and organizational commitment. Explanations and directions for future research are discussed. (shrink)

In creative cognition research, the Romantic view about creative cognition is traditionally rejected in favor of the modern view. The modern view about creative cognition maintains that creativity is neither mysterious nor unintelligible and that it is indeed susceptible to analysis. The paradigmatic objects of analysis in creative cognition research have been creative output and the creative process. The degree of creativity of an output is assessed in accordance with certain criterial definitions. The degree of creativity of a cognitive process (...) is assessed in accordance with certain models of creative cognition, psychometric test measures, and neuroimaging studies that are grounded in certain criteria for assessment. The reliance on criterial definitions and criteria for assessment in analyzing either the creative output or the creative process suggests that creative cognition researchers remain under the sway of the classical, bundles-of-criteria theory of meaning. In this paper, I will critically evaluate the criterial problems that confront both criterial definitions and criteria for assessment before proposing an alternative theory of meaning. (shrink)

Confucian state doctrines have shaped Asian cultures for millennia as prescriptive codes of conduct with an emphasis on hierarchy and obligation. Yet a premise at the core of lǐ —understood as propriety, ritual, or generally a cultural grammar—is authenticity, and authentic respect cannot be commanded. What if the lǐ were to be elegant instead? Hans-Georg Gadamer analyzed play as a fusion of horizons that are absorbed into the same event, co-constituting subject and object in an aesthetic experience, and dissolving their (...) dichotomy. We consider examples from Japanese aesthetics in this framework to give depth to key Confucian concepts: the values that enable a relationality that is not in conflict with autonomy; the points of reference for self-improvement through culture; a social organization that enacts reciprocity; and the essential posture this requires. The radical simplicity of the philosophy of tea, chanoyu, and the aesthetic refinement of the Katsura Rikyū palace illuminate the principle of emotional resonance in encounters, which underlies the fusion of cognitive, ethical, and aesthetic horizons. This view reveals how the relational premise of the Confucian philosophical system entails an ontological commitment to mutuality. This is indeed ethics, but neither particularism nor generalism; in its aesthetic dimension it is the mode of perception of a self fulfilled in play. (shrink)

Abstract Chinese culture has remained steady, stretching through time as long and unbroken as the Great Wall. In thousands of years, Chinese culture has exhibited a remarkable ability to assimilate foreign intrusions. Even though several times throughout Chinese history minority nationalities have been in military and political control of China, they were gradually assimilated by Chinese culture. Christianity has spent more than a thousand years attempting to convert the Chinese with only negligible success. However, why was Marxism able to become (...) the dominant ideology in only 30 years? This article discusses the critical cultural roots of the different destinies of Marxism and Christianity within the Great Wall. (shrink)

Risk management has become a vital topic both in academia and practice during the past several decades. Most business intelligence tools have been used to enhance risk management, and the risk management tools have benefited from business intelligence approaches. This introductory article provides a review of the state-of-the-art research in business intelligence in risk management, and of the work that has been actepted for publication in this issue.

Histone post-translational modifications play important roles in transcriptional regulation. It is known that multiple histone modifications can act in a combinatorial manner. In this study, we investigated the effects of multiple histone modifications on expression levels of five gene categories in coding regions. The combinatorial patterns of modifications for the five gene categories were also studied in the regions. Our results indicated that the differences in the expression levels between any two gene categories were significant. There were some corresponding differences (...) in multiple histone modification levels among the five gene categories. Multiple histone modifications jointly impacted expression levels of every gene category. Four mutual combinations of histone modifications were found and analyzed. (shrink)

Educators themselves and their knowledge are the most significant elements in learners’ success and achievement; however, there is little information about the specialized knowledge held by educators. Recently, conceptualizing educator knowledge has become a complicated issue that involves that the comprehension of important basic phenomena, such as the procedure of educating and learning, the notion of knowledge, and the way educators’ knowledge, has become practical within the class. Technological Pedagogical Content Knowledge was presented as a theoretical structure for the knowledge (...) base because educators have to efficiently instruct with technology and it is regarded as a valuable framework for explaining and understanding technology integration into various academic environments, such as English as a Foreign Language class. This paper is intended to review the related literature on the role of an English teacher using the TPACK framework for teaching English and their role in students’ achievement. Based on the related literature, there is a significant and direct association between EFL teachers’ TPACK and EFL students’ achievement. Succinctly, some recommendations have been proposed for educational stakeholders. (shrink)

Fezf1 and Fezf2 are highly conserved transcription factors that were first identified by their specific expression in the anterior neuroepithelium of Xenopus and zebrafish embryos. These proteins share an N‐terminal domain with homology to the canonical engrailed repressor motif and a C‐terminal DNA binding domain containing six C2H2 zinc‐finger repeats. Over a decade of study indicates that the Fez proteins play critical roles during nervous system development in species as diverse as fruit flies and mice. Herein we discuss recent progress (...) in understanding the functions of Fezf1 and Fezf2 in neurogenesis and cell fate specification during mammalian nervous system development. Going forward we believe that efforts should focus on understanding how expression of these factors is precisely regulated, and on identifying target DNA sequences and interacting partners. Such knowledge may reveal the mechanisms by which Fezf1 and Fezf2 accomplish both independent and redundant functions across diverse tissue and cell types. (shrink)

Ethiopian Jewish immigrants in Israel are one of the most ancient communities in the world, one that has been detached from the known Jewish world for about 2,500 years. Throughout this very long period of isolation, the Ethiopian Jewish community maintained Jewish tradition and dreamed over the centuries to unite with the rest of the Jewish world and immigrate to the Jewish state—Israel. But this transition occurred within a short time from an agrarian society in Ethiopia (traditional culture) with an (...) oral culture to a knowledge society in Israel (modern culture) with a written culture. Most studies that examine cultural transition focus on anthropological, sociological, and cultural aspects; but there are nearly no studies that examine the technological knowledge of non-literate populations. The purpose of this study is to examine and characterize technological knowledge among this population—the case of Ethiopian non-literate immigrants in Israel. The study involved in-depth interviews to examine technological knowledge through using technological appliances in their everyday life, assembly of two simple technological systems, and a home technology profile compared to the general population in Israel. Participants included 50 non-literate Ethiopian immigrants between the ages of 40–60. The results of our study are surprising in that we have shown that non-literate immigrants adapt to a technology-rich environment at an average degree with respect to the general population in Israel. Also, comparing technological knowledge between traditional and modern cultures shows participants’ wide range of knowledge without ability to read and write. Illiteracy does not preclude the development of knowledge in general, technological knowledge particularly, and does not prevent non-literate populations from acquiring knowledge in a new environment. (shrink)

This book is an abridged version of Feng Qi’s two major works on the history of philosophy, The Logical Development of Ancient Chinese Philosophy and The Revolutionary Course of Modern Chinese Philosophy. It is a comprehensive history of Chinese philosophy taking the reader from ancient times to the year 1949. It illuminates the characteristics of traditional Chinese philosophy from the broader vantage point of epistemology. The book revolves around important debates including those on “Heaven and humankind” (tian ren天人), “names and (...) actualities” (mingshi名實), “principle and vital force” (liqi理氣), “the Way and visible things” (daoqi道器), “mind and matter/things” (xinwu心物), and “knowledge and action” (zhixing知行). Through discussion of these debates, the course of Chinese philosophy unfolds. Modern Chinese philosophy has made landmark achievements in the development of historical and epistemological theory, namely the “dynamic and revolutionary theory of reflection”. However, modern Chinese philosophy is yet to construct a systematic overview of logic and methodology, as well as questions of human freedom and ideals. Amid this discussion, the question of how contemporary China is to “take the baton” from the thinkers of the modern philosophical revolution is addressed. (shrink)

Background: Greater vulnerability to negative emotions appears associated with the development and maintenance of eating disorders. A systematic review of psychophysiological studies using emotion-eliciting film clips reveals that there are no studies examining the effect of standardized validated film clips on psychophysiological response across a range of EDs.Methods: Using standardized validated film clips without ED-specific content, the present study examined self-reported emotions and psychophysiological responses of women with Binge-Eating Disorder, Anorexia Nervosa, Bulimia Nervosa, and Healthy Controls at Baseline, during Neutral, (...) Sad, Happy, and Fear-inducing film clips, and at Recovery.Results: Throughout the protocol, the ED groups reported significantly greater sadness and anxiety than HCs. Additionally, the AN group reported more fear, the BED group more frustration, and the BED and BN groups more tension than HCs. Compared to HCs, the BED group reported stronger urges to binge throughout the protocol, whereas BN group reported stronger urges to binge relative to the HC group only at Baseline and Recovery. The BN and BED groups experienced decreased urges to binge during all film clips compared to Baseline. Respiratory Sinus Arrhythmia levels were significantly lower in the BED group compared to HCs and the BN group throughout the protocol.Discussion: Standardized validated film clips can be used to elicit expected self-reported emotion and skin conductance responses in ED groups, although individuals with EDs compared HCs report greater negative emotions. Interestingly, film clips appeared to reduce urges to binge in binge-eating groups. (shrink)

The National Health Service in the United Kingdom categorises research and research-like activities in five ways, such as ‘service evaluation’, ‘clinical audit’, ‘surveillance’, ‘usual practice’ and ‘research’. Only activities classified as ‘research’ require review by the Research Ethics Committees. It is argued, in this position paper, that the current governance of research and research-like activities does not provide sufficient ethical oversight for projects classified as ‘service evaluation’. The distinction between the categories of ‘research’ and ‘service evaluation’ can be a grey (...) area. A considerable percentage of studies are considered as non-research and therefore not eligible to be reviewed by the Research Ethics Committee, which scrutinises research proposals rigorously to ensure they conform to established ethical standards, protecting research participants from harm, preserving their rights and providing reassurance to the public. This article explores the ethical discomfort potentially inherent in the activity currently labelled as ‘service evaluation’. (shrink)